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Abstract

Heart failure resulting from myocardial infarct,
oxygen-deprived tissue death, is a serious disease that affects
over 20 million patients in the world. The precise injection of
tissue-engineered materials into the infarct site is emerging as a
treatment strategy to improve cardiac function for patients
with heart failure. We have developed a novel miniature
robotic device (HeartLander) that can act as a manipulator for
precise and stable interaction with the epicardial surface of the
beating heart by mounting directly to the organ. The robot can
be delivered to and operate within the intrapericardial space
with the chest closed, through a single small incision below the
sternum. The tethered crawling device uses vacuum pressure to
maintain prehension of the epicardium, and a drive wire
transmission motors for actuation. An onboard electromagnetic
tracking sensor enables the display of the robot location on the
heart surface to the surgeon, and closed-loop control of the
robot positioning to targets. In a closed-chest animal study with
the pericardium intact, HeartLander demonstrated the ability
to acquire a pattern of targets located on the posterior surface
of the beating heart within an average of 1.7 ± 1.0 mm. Dye
injections were performed following the target acquisitions to
simulate injection therapy for heart failure. HeartLander may
prove useful in the delivery of intrapericardial treatments, like
myocardial injection therapy, in a precise and stable manner,
which could be performed on an outpatient basis.